Tuesday, October 16, 2012

"Pain-Free Medicine"

The man was a Maestro.I was in awe of his abilities.A
self-described businessman, I looked on in amazement as, with deftness,
subtlety and expertise, the man ingeniously went about his business.

Not long ago, along with other
interested patients, I attended a gathering, hosted by the “Maestro”, at which a
new wrinkle would be unveiled in my “Primary Care” doctor’s medical
practice.It’s what they call “Concierge”
service.

“We take your blood pressure, and get you tickets to hit
shows.”

No.It’s not that.

With “Concierge” service, patients willing to pay nineteen
hundred dollars a year, would be provided, along with a comprehensive annual
physical, extended office visits, a variety of “Wellness” consultations, and
the doctor’s private phone number and e-mail address for direct and instant
contact.The “Maestro” represented the
company – or for all I know owned the
company – that would administer the program.

(This is not an “all included” program.Regular office visits would continue to be
paid for through insurance.With the
“Concierge” service, those office visits would now, however, be longer.)

We were ushered into a brightly lit room in a Marina Del Rey
hotel, the glass-sided entryway offering a panoramic vistas of boats of various
sizes and luxuriousnesses, bobbing in the harbor.

Set out on tables was a generous array of fruit and cheese platters,
along with a tray of oversized cookies (that, to my eye, did not appear to be that
healthy.)Coffee and tea were also available.

Though I have never been to one, the entire operation
conjured the image of a seminar hawking “Time Shares” on Maui.

As the attendees settled in, the “Maestro” moved confidently
to the podium where, in relaxed and easy manner, he outlined the event’s itinerary,
assuring us it would be wrapped up in an hour.After offering an introductory overview, the “Maestro” would introduce our doctor who would
briefly address us.There would then be
an eight-minute promotional video, after which the “Maestro” would explain the
program in further detail.The event
would conclude with fifteen minutes where the “Maestro” welcomed questions from
the audience.

It was pain-free medicine.Easy-peasy.

Before introducing our doctor, the “Maestro” confided that
some doctors feel extremely nervous addressing large groups.On a previous occasion, the “Maestro” had advised
a stage-frightened doctor to just imagine the entire audience naked.The doctor replied that that wouldn’t work,
because he had already seen the entire audience naked.After the appropriate laughter, the “Maestro”
assured us that that was a “true story.”

Our doctor got up and addressed up, explaining that, among
other advantages of the “Concierge” program, with the now longer office visits,
he would not be required to talk as fast, adding that we probably had never
heard him speak this slowly before.The
odd thing was that, when he said that, he was speaking as fast, or faster, than
ever.

Regaining the reins of the proceedings, the more sure-handed
“Maestro introduced the video, which explained how the “Concierge” treatment
approach would return us to the “Good Old Days”, when doctors had ample time to
spend with each patient, and could therefore more successful administer to
their needs, an arrangement lost because, in order to make ends meet, doctors
were required to see more and more patients per day.

The “Maestro” then ended with a truly agonizing story of personal
misfortune, not to garner sympathy, but to exemplify the fact that the crisis
was considerably worsened by the lack of a personal and direct relationship with a doctor,
which the “Concierge” system was now available to alleviate.

The audience questions were highly illuminating.You could not have scripted them to more
astutely challenge the premises of the program.Question:“I’m young and
healthy.What do I need this for?”The “Maestro’s” response:“The ‘Concierge’ program will help you stay healthy. ”

Question:“Understanding
that the ‘Concierge’ system will only be in effect a couple of hours a day, how
will this change things for patients who choose not to sign up?”The “Maestro’s” response:“There will be differences, but you will not
feel like ‘the sky is falling’, due to ‘natural attrition’ – the doctor will
not be taking on any new patients, some patients will be moving on, and some
will no longer need medical services…because they have passed away.”

The “Maestro” actually said that.And got away with it.

The “Maestro” negotiated the Q and A, and the entire seminar
for that matter, with remarkable dexterity. He said precisely the right things, never a wrong word, never an endangering misstep.It was a virtuoso performance. Like watching a
veteran combatant, negotiating a minefield, entirely unscathed.

Basically, what was being offered to us was a system that
required patients to pay nearly two thousand dollars extra per year for medical
services that had once been considered normal and expected, but were lost
because doctors bloated their “Patient Rosters” to maximize their incomes.They now no longer had to do that, because
they could make just as much money, or even more, by going “Concierge.”

The underlying issue here was money.The “Maestro’s” absolutely “genius”
performance, however, left the overpowering impression that they were doing
this for us.